Organization
MEDFUND LLC
Active
Other names
Horizon Jacksonville North LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN J KERN (SENIOR VICE PRESIDENT)
(941) 925-3490
Entity
Organization
Contact information
Practice address
6349 BEACH BLVD, STE 1A, JACKSONVILLE, FL 32216-2756
(904) 722-3939
(904) 722-3922
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(941) 953-4452
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
HCC5206
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105715-14
CITRUS HMO
FL
01
—
V2379
BCBS PROVIDER #
FL
Enumeration date
05/23/2005
Last updated
08/22/2020
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